Technical aspects of Nephron-Sparing Surgery (NSS) in children with bilateral centrally located renal tumors
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In brief
In brief
This technical review addresses surgical strategies for bilateral nephron-sparing surgery in children with centrally located renal tumors, where involvement of collecting systems and proximity to renal vessels pose significant challenges. The authors emphasize that experienced surgeons can achieve successful resections even in complex cases that appear unfavorable on imaging, potentially avoiding total nephrectomy.
Written by the GCMD Library team from the article.
Publication date: Available online 15 November 2019
Source: Seminars in Pediatric Surgery
Author(s): Steven W. Warmann, Jörg Fuchs
Abstract
Bilateral Nephron-Sparing Surgery (NSS) is the gold standard as surgical treatment for children suffering from bilateral renal tumors. Whereas this approach is easy to achieve in peripheral tumors, it represents a relevant challenge in lesions that are centrally located. Involvement of the collecting system, localization deep within the renal parenchyma, and proximity to the central renal vessels are often difficult to deal with. A relevant number of patients thus receive unilateral total nephrectomy or undergo incomplete resections. However, surgery can often be performed successfully through experienced surgeons in centers of excellence, even though conditions for resection appear dismal on preoperative imaging. In this article the authors describe technical aspects of Nephron-Sparing Surgery in complex conditions of bilateral pediatric renal tumors.